Hypothermia is a condition in which core temperature drops below that required for normal metabolism and body functions which is defined as 35.0 °C (95.0 °F).
The signs and symptoms of mild hypothermia include vigorous shivering, increased blood pressure, core body temperature less than 98.6F(37.6C) but greater than 95.6F (35.6C), fine motor skill impairment, lethargy, apathy and mild amnesia. Signs of moderate and severe hypothermia include cessation of shivering, very cold skin, depressed vital signs, core body temperature between 90.6F (32.6C) and 95.6F (35.6C) for moderate hypothermia or below 90.6F (32.6C) for severe hypothermia, impaired mental function, slurred speech, unconsciousness and gross motor skill impairment.
Frostbite is the condition where localized damage is caused to skin and other tissues due to extreme cold. Frostbite is most likely to happen in body parts farthest from the heart and those with large exposed areas. The initial stages of frostbite are sometimes called "frostnip". Be aware of signs and symptoms of superficial frostbite, which include swelling, redness or mottled gray skin appearance, stiffness and transient tingling or burning. Be aware of signs and symptoms of deep frostbite, which include edema, mottled or gray skin appearance, tissue that feels hard and does not rebound blisters, and numbness or loss of sensation.
What to do: The decision to re-warm a subject is contingent upon resources available and likelihood of re-freezing. Re-warming can occur at room temperature or by placing the affected tissue against another person’s warm skin. Re-warming should be performed slowly, and water temperatures greater than 98.6F to 104.6F should be avoided. To re-warm, the affected tissue should be immersed in a warm water bath. The water will need to be gently circulated, and the area should be immersed for 15 to 30 minutes. Thawing is complete when the tissue is pliable and color and sensation have returned. In addition, re-warming can result in significant pain, so a physician may prescribe pain medication.
Those suffering from heat stroke are considered a medical emergency. Heat stroke is the failure and subsequent shutdown of the body's ability to control the body's temperature. Those suffering from heat stroke do not appear to be sweating. Heat stroke can occur within a matter of hours during exercise in hot humid weather. Violent behavior followed by unconsciousness is a classic characteristic of heat stroke. The athlete's skin may feel hot compared with the expected findings of heat exhaustion, in which the skin tend to feel damp and cool. The body's core temperature will increase to that more than 105 degrees F. This puts the body's organs, especially the brain at a tremendous risk. As brain function diminishes, the pupils become fixed and dilated. If untreated, death may occur from heat stroke after 20 minutes. The body must be cooled in the same manner as that described for heat exhaustion and treatment by a doctor.
Heat exhaustion is characterized by sudden, extreme fatigue as the body attempts to supply blood to the brain, exercising muscles, and skin. This is generally caused by a decrease in water, salt and electrolytes within the body. Symptoms of heat exhaustion include sweating, vomiting, diarrhea, and excessive urination. All of these are predisposing factors to heat stroke if not treated properly. Individuals suffering from heat exhaustion have a rectal temperature of 103 degrees F and present with profuse sweating, causing the skin to feel cold and clammy. Pulse and respiration are rapid, but loss of fluids causes the pulse to feel weak and reduces blood pressure. Individuals with heat exhaustion generally complain of a headache and appear to be fatigued and confused.
Heat cramps are managed by controlling symptoms of dehydration with replacement of electrolytes and fluids. While on the field, heat cramps should be stretched and massaged until the cramp subsides. If the cramp is not resolved, the athlete may be brought to the side lines where ice bags can be placed upon the cramping muscle. Fluids are administered to the athlete for re-hydration. The athlete may return to play once the cramping subsides. Re-hydration is encouraged through out competition.
Heat syncope (fainting) is often in conjunction with heat exhaustion. Fainting spells are caused by hot, humid environments. The unconsciousness or dizziness associated with syncope occurs in the absence of an elevated core temperature. The athlete should be removed from activity and allowed to relax in a cool environment. Fluids should be replenished and core body temperature should be decreased with cold compresses in areas where arteries are more superficial to the surface of the body (ie back of the knees, groin area, armpits, and neck).
Management of heat injuries and illnesses requires treatment with cool water for re-hydration. Electrolytes, especially salt, need to be replaced within the athlete's body. Such electrolytes can be found in sport drinks such as Gatorade, Powerade, etc. Dehydration signs and symptoms include thirst, irritability, and general discomfort in the beginning initial stages and can intensify into headaches, weakness, dizziness, cramps, chills, vomiting, nausea, and decreased performance in the late stages. If not treated properly or detected, dehydration can lead to heat cramps, heat exhaustion, and heat stroke.